Summary

Responsible for design and buildout of trend prediction capabilities across key clinical and affordability metrics, this individual will build expert-level clinical metrics into the broader CHC Risk Ecosystem. Candidates should be very familiar with the intersection of clinical data with predictive techniques including authorization data, service category, and diagnosis drivers. Key stakeholder groups include clinical and affordability teams, analytics, and finance.

Responsibilities

• Buildout key clinical risk indicators and projection insights into the CHC Risk Ecosystem

• Partner with clinical & financial stakeholders to design and implement effective clinical analysis capabilities and key performance indicators into trend analysis & claim insights

• Unpack relationships between key clinical drivers, including authorizations, claims, diagnostic categories, and episodes of care in the CHC Risk Ecosystem

• Own end-to-end development of innovative clinical insights and affordability opportunities, seeking continuous improvement

• Influence the cost of care through enhancement of predictive capabilities to deliver data-driven insights

• Utilize external data to drive deeper connections between internal clinical data and marketplace trends

• Leverage large datasets in analysis, partnering with technical and visualization teams as applicable

• Serve as a strategic business partner with multiple cross-functional areas including clinical, financial, and technical stakeholders to improve operational efficiency, accuracy, and depth of data-driven clinical insights

Qualifications

• 5+ years' of experience in medical economics/health-plan data analytics, affordability or clinical analysis

• Advanced experience with SQL, Python and/or other similar data tools

• Familiar with key clinical coding (CPT/ICD10) concepts and data

• Proven core clinical knowledge including provider data, clinical information, claims data and health plan performance including cost and quality objectives

• Experience in working successfully in a matrix environment with demonstrated ability to collaborate

• Effective storytelling skills and business acumen are key competencies

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 98,200 - 163,600 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.

About The Cigna Group:

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: See Yourself@cigna.com for support. Do not email See Yourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.